The Awareness Wheel

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As I reflect over the past legislative session and more recently over my past week as I met with each of my bosses and collaborators as well as legislators and other elected officials, I thought I would share a helpful communication tool I learned while completing my DNP.

As we learned about organizational development and self-reflection on our behavioral tendencies, we also learned strategies for communication, especially where there is a conflict or hot button issue.

One of my jobs is in a Free Clinic. This is not a Federally Qualified Healthcare Center, but it is a safety net clinic. We only see people who have no health insurance and live <200% FPL. We have a single major donor and a few very small additional donors.

During the week, I am the only provider and I have an office manager. Between the two of us, we complete eligibility screening, provide primary care services for patients, order medications, write referrals, reach out to community partners, look for other funding sources such as grants, provide patient navigation, and respond to our patients’ questions and concerns.

I have been using the Awareness Wheel as a way to help articulate my concerns and requests in a non-judgmental manner to facilitate true communication rather than conflict. If you are not familiar with this tool, there are many variations. I prefer the, ‘Facts,’ ‘I Feel,’ ‘I Imagine,’ and ‘I Request’ model.  Below, I will demonstrate how it may be used.

Facts: The Free Clinic is a safety net clinic providing coordinated healthcare services, through a network of community partners, to those who have no other access to healthcare. Currently, our network is very small and we are unable to meet many of the needs of the patients we serve. Everyday, the office manager and I work hard to care for patients with our very limited resources.

I Imagine: I imagine that the Board of Directors and the Clinical Operations Committee shares the clinic vision and want to do everything possible to fulfill this vision and beyond.

I Feel: I feel that my ideas for creating a sustainable comprehensive network of community partners and reaching out to the wider community in which the clinic is located are not clearly heard.

I Want: I want to be a part of building the foundation of the Free Clinic to create sustainable partnerships throughout northern Virginia. I want all of us to diligently reach out to all community partners who would help us to provide comprehensive healthcare services for our patients. I want to develop partnerships with Universities and larger healthcare organizations to be able to create new models of healthcare that keep the patient at the center of everything we do at the Free Clinic.

I hope you find this tool useful as you communicate with your colleagues, collaborators, partners and legislators. It has worked well for me!

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About Author

Rebecca Bates, DNP
Rebecca Bates, DNP

Rebecca Bates, who has been a nurse since 2000, is passionate about providing healthcare for vulnerable populations. She earned her DNP at Old Dominion University, Norfolk, Va., and has been a family nurse practitioner in primary care since 2009. Her DNP research explored NP assessment of adolescent psychosocial risk factors. During her doctoral program, she completed a health policy fellowship and remains active in state and federal health policy advocacy. She has also engaged in global health advocacy and medical missions. She recently left private practice and currently works at a Free Clinic where she continues to precept NP students. She is an assistant professor for graduate and undergraduate nursing students. Rebecca believes nurses must have a seat at the table to improve the health of individuals and communities throughout the world.

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